Sugar-free doesn’t always mean heart-friendly: What a new study says about xylitol

In the Canadian cohort, “over a follow-up period of 6 years, people with the highest blood xylitol levels had a 57 per cent higher risk of a major cardiovascular event compared with those with the lowest levels. In the UK cohort, people with the highest blood xylitol levels had an 18 per cent higher risk than those with the lowest levels.”

As per the study, “Over a follow-up period of 30 years, the risk of major adverse cardiovascular events was 18% higher in those with the highest levels vs. the lowest levels in the EPIC-Norfolk cohort. ”

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.

Does this mean xylitol causes heart attacks?

No. The study was observational, meaning it found an association but cannot establish that xylitol itself caused the cardiovascular events.

“These findings should be interpreted with caution because this was an observational study and blood xylitol levels do not directly tell us how much xylitol a person consumed,” Dr Punya Pratap Kujur, Consultant Cardiologist, Gleneagles Hospital, Parel, Mumbai, tells indianexpress.com.

There is another reason to be cautious about interpreting the findings. The researchers measured blood xylitol levels, rather than directly measuring how much xylitol participants consumed. And xylitol isn’t only obtained through food: the body naturally produces it as part of metabolism as well.

“Xylitol can also be produced naturally by the body, so a high blood level does not necessarily mean a person is consuming more of it,” Dr Kujur notes.

The cardiologist says that while the findings raise questions about possible metabolic or cardiovascular pathways, “At this stage, we should not conclude that xylitol causes heart attacks or strokes; more research is needed to understand whether the association is causal and what biological mechanisms may be involved.”

How could xylitol potentially affect the heart?

If xylitol increases platelet reactivity, it could potentially make platelets more likely to stick together and form clots (Envato image)

One area researchers are investigating is platelet activity. Platelets help the blood clot when you are injured. If they become excessively reactive, they can stick together and contribute to clot formation.

“If xylitol increases platelet reactivity, it could potentially make platelets more likely to stick together and form clots,” Dr Kujur explains.

A clot blocking a coronary artery can restrict blood flow to the heart and cause a heart attack. If a clot blocks an artery supplying the brain, it can result in an ischaemic stroke. However, Dr Kujur stressed that this proposed mechanism is still being studied and does not establish that consuming xylitol causes either condition.

Should you stop consuming xylitol?

For now, there is no need to panic or completely stop using xylitol-containing products based on this study alone.

“More research is needed before changing dietary recommendations based on these findings alone,” Dr Kujur assures.

People with established cardiovascular disease or a high risk of blood clots may nevertheless choose to consume such products in moderation until stronger evidence becomes available. For everyone else, the bigger picture remains more important: a balanced diet, regular physical activity, not smoking and keeping established cardiovascular risk factors such as blood pressure, cholesterol and diabetes under control.

The study is therefore less a verdict on xylitol and more a new question for researchers to investigate: whether a sweetener widely viewed as a healthier alternative could have cardiovascular effects that we do not yet fully understand.

As Dr Kujur put it, “The overall diet and proven heart-health measures remain much more important.”

“This study is important because it highlights a possible cardiovascular association that needs further investigation. However, patients should not panic or make major dietary changes based on one observational study. Until stronger evidence is available, moderation and a heart-healthy overall diet remain the sensible approach, Dr Kujur concludes.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.